Methods for reduction of gastric lumen

Abstract

A method of reducing the cross-sectional area of a gastrointestinal lumen is provided wherein a delivery catheter having a needle, one or more anchors disposed within the needle and a suture coupled to each anchor is advanced into the gastrointestinal lumen, the needle extended through the tissue wall, and an anchor ejected from a distal tip of the needle through the tissue wall. The needle is then repositioned against an opposing tissue wall, another anchor deployed from the needle through the opposing tissue wall, and the tissue walls approximated by applying tension to the sutures.

We claim: 
     
         1 . A method comprising:
 providing a delivery catheter including a piercing element at a distal end of the catheter, one or more anchors within the catheter and a suture coupled to the anchors, with at least one of the anchors comprising a sleeve of braided material and an eyelet for coupling the anchor to the suture;   advancing the delivery catheter to a target tissue within the body of a patient;   advancing the piercing element through a first tissue wall, and then through a second tissue wall;   ejecting a first anchor from the piercing element on a first side of the first tissue wall, and ejecting a second anchor from the piercing element on a second side of the second tissue wall; and   advancing a fastener over the suture whereby a tension is applied to the suture, the fastener comprising a collar having a central channel through which the suture extends;   such that the first and second anchors and the suture hold the first tissue wall adjacent to the second tissue wall.   
     
     
         2 . The method of  claim 1 , further comprising:
 providing a stabilization device at or near a distal end of the delivery catheter; and   engaging the stabilization device to the first tissue wall before advancing the catheter through the first tissue wall.   
     
     
         3 . The method of  claim 2 , wherein the stabilization device comprises a tissue holding element. 
     
     
         4 . The method of  claim 1 , further comprising:
 providing an imaging element in the vicinity of the distal end of the delivery catheter; and   using the imaging element to provide visual guidance.   
     
     
         5 . A method for creating a tissue fold, comprising:
 providing a delivery catheter having a translatable needle and an anchor disposed within the needle and a suture coupled to the anchor, the anchor comprising a sleeve of braided material and an eyelet for coupling the anchor to a suture;   engaging and pulling a tissue wall within the body of a patient to create a tissue fold;   extending the needle through the tissue fold;   ejecting the anchor from the needle;   withdrawing the needle from the tissue fold whereby the suture is extended through the tissue fold;   translating a fastener over the suture; and   maintaining the tissue fold via the anchor and the suture.   
     
     
         6 . The method of  claim 5 , further comprising: providing a second anchor including a suture coupled thereto; and creating a second tissue fold on an opposing tissue wall. 
     
     
         7 . A method comprising:
 moving a catheter into a patient;   holding a first portion of tissue within the patient;   extending a piercing element from the catheter through the first portion of tissue;   moving a first anchor out from the piercing element, on a first side of the first portion of tissue;   withdrawing the piercing element from the first portion of tissue;   moving a second anchor out from the piercing element, on a second side of the first portion of tissue, with at least one of the first anchor and the second anchor comprising a sleeve of braided material and an eyelet for coupling the anchor to a connection element;   holding the first portion of tissue via a connection element connecting the first and second anchors; and   advancing a fastener over said connection element to apply a tension force on said connection element.   
     
     
         8 . A method of creating a tissue fold comprising:
 moving a catheter to a surgical site of a patient;   engaging and pulling a tissue wall to form a tissue fold;   pushing a piercing element extending out of the catheter through the tissue fold;   ejecting a first anchor from the piercing element;   withdrawing the piercing element from the tissue fold;   ejecting a second anchor from the piercing element, said second anchor being connected to said first anchor by a suture, with at least one of the first anchor and the second anchor comprising a sleeve of braided material and an eyelet for coupling the anchor to the suture; and   advancing a fastener over said suture to apply a tension force on said suture;   with the anchors and the suture maintaining the tissue fold.   
     
     
         9 . The method of  claim 8  wherein bringing the first and second tissue walls adjacent results in reducing the cross sectional area of an opening in the patient. 
     
     
         10 . The method of  claim 8  wherein bringing the first and second tissue walls adjacent results in reducing the volume of an organ of the patient. 
     
     
         11 . The method of  claim 8 , further comprising:
 providing an imaging element in the vicinity of the distal end of the catheter; and   using the imaging element to provide visual guidance during the step of pushing a piercing element extending out of the catheter through the tissue fold.   
     
     
         12 . The method of  claim 8 , wherein ejecting a first anchor from the piercing element comprises translating a push rod disposed in the piercing element. 
     
     
         13 . The method of  claim 8 , wherein pushing a piercing element extending out of the catheter through the tissue fold further comprises translating the piercing element distally through the catheter.